71 - Imaging of the Spine

Question 1

Most useful spinal imaging modality

Answer 1

MRI (easier to see nerves and discs than CT)

Question 2

Features of lumbar vertebrae morphology

Answer 2

Thick vertebral body
Triangular-shaped vertebral canal
Thick laminar
Superior facet and inferior facet articulate posteriorly 
Concave shape of vertebral body

Question 3

Good to look at the slides of this lecture

Answer 3

.

Question 4

Use of an oblique angle X ray

Answer 4

Good for viewing neck pars-articularis

Question 5

Articulations between vertebra
1
2

Answer 5

IV discs

Facet joints - zygahypophyseal joints

Question 6

Spaces between vertebra 
1
2
3
4

Answer 6

– Intervertebral foramina
– Spinal canal
– Intelaminar
– interspinous

Question 7

Appearance of anulus and nucleus on an MRI

Answer 7

T1 - Whole structure is grey

T2 - Nucleus is light, anulus is dark

Question 8

Things exiting through IV foraminae

Answer 8

Superior to inferior:
Nerve root
Artery
Veins

Question 9

Epidural fat

Answer 9

Fat that lies anterior and posterior to spinal cord within IV canal

Question 10

What surrounds structures in exit foraminae?

Answer 10

Fat

Question 11

What does a protruding lumbar IV disc impede on?

Answer 11

Nerve root exiting below disc.

Question 12

Appearance of anterior longitudinal ligament on MRI

Answer 12

Blends with IV discs

Question 13

Appearance of ligamentum flavum on MRI

Answer 13

Low signal intensity.

White bump between vertebrae, on posterior side

Question 14

Difference in facet orientation between T and L vertebrae

Answer 14

T point posterior

L point 45 degrees, facing each other

Question 15

Advantage of CT over MRI

Answer 15

Better bone detail (so better at detecting fractures, imaging complex joints).

Question 16

Bone scintigraphy 
1
2
3
4

Answer 16

• Injected technetium emits gamma rays –
counted by scanner
• Technetium taken up by osteoblasts
• Bone scintigraphy assesses vascularity and
osteoblastic activity
• Over areas of abnormality there should be an area of particularly dense technetium

Question 17

Bone densitometry 
1
2
3
4

Answer 17

• Dual energy Xray Absorptiometry
• Uses low dose radiation (X-rays) to measure
bone mineral density (BMD)
• Compares measured BMD of the femoral neck
or lumbar spine with age-matched reference
ranges (Z score) or young normals (T score)
• Combined with other clinical information can
give a risk of fracture